Organization
PAGE FAMILY MEDICINE
Active
Parent organization
PHYSICIANS IMMEDIATE CARE OF TWIN FALLS
Other names
c/o PHYSICIANS IMMEIDATE CARE OF TWIN
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHYSICIANS IMMEDIATE CARE OF TWIN FALLS
Authorized official
JEREMY B HAYMORE MD (MEDICAL DIRECTOR)
(208) 312-2242
Entity
Organization
Contact information
Practice address
1252 BENNETT AVE, SUITE B, BURLEY, ID 83318
(208) 617-0656
(208) 647-0659
Mailing address
260 FALLS AVE STE C, TWIN FALLS, ID 83301-3370
(208) 736-7422
(708) 736-8905
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-4391
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487151882
—
ID
Enumeration date
04/11/2018
Last updated
02/01/2019
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